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Your mentor is putting a patient at risk - what do you do?

  • 7 Comments

What would you do in this situation?

Let us know how you would deal with this situation for your chance to win a copy of the book it came from: Patient Safety and Managing Risk in Nursing. Use the comment section below to have your say.

Your mentor is putting a patient at risk - what do you do?

“Patricia has been assigned as your mentor throughout your eight-week community practice placement. She is a very experienced staff nurse and has been qualified for 28 years. 

“You believe Patricia to be a fantastic role model and mentor, with only one exception, and that is related to the technique she uses when administering subcutaneous Tinzaparin. Her technique is poor and you observe that there is an obvious gap between Patricia’s theoretical knowledge base and current recommended best practice and local guidelines. 

“For three consecutive days you have watched Patricia administer subcutaneous Tinzaparin to Bill using a poor technique. Bill was discharged from hospital after having a total hip replacement. 

“You know that Bill will need to have subcutaneous Tinzaparin daily for four weeks after his surgery to prevent venous thromboembolism as this is the recommended best practice. 

“If Patricia continues to use such a poor technique when administering the injection, you know the therapeutic benefits will be greatly reduced and Bill could potentially suffer harm. 

“…the therapeutic benefits will be greatly reduced and Bill could potentially suffer harm

“You know that Bill is not receiving a therapeutic dose of Tinzaparin and, although he is not in any immediate danger, you worry that over time he is more likely to develop a VTE. 

“This situation, if allowed to continue, could have a very serious outcome for Bill.”

  • Would you feel able to approach this situation with Patricia? 
  • What strategies might you use to do so?
  • If you did decide to raise concerns, who would you raise them with?

 

  • 7 Comments

Readers' comments (7)

  • It doesn't mention what the nurse is doing wrong with the technique but the best approach would be that the student was recently shown a video in school and the new way of doing it is this....... that way you are not coming across as being cocky or picky. Then take it from there as to how the nurse reacts to you.

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  • Louise Goodyear

    I would maybe say to her to get her to question her own practice, "have you seen this article about injection techniques" and see how she responds. She may read it and realise she needs refreshing on her skills, so undertakes a skills day. Or maybe she does not, in that case I would speak to her line manager/ward manager to ask how nurses injection techniques are evaluated and if you mentor has had her, then it leaves it open then for your mentor and the line manager. You would need to ask in a diplomatic way that does not cause her offence as she would be a very skilled nurse but maybe just lacks some confidence in her injection technique. Its about protecting your patients at all times, as student nurses we are the eyes and ears and sometimes staff on placements become complacent and it isnt until a student or NQ comes onto their area that they realise they may need to fresh their skills. I will always speak up if I witness bad practice etc, the care of our patients and protecting them is our concern at all times.

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  • this happened to me! I said that we had been shown a different way to administer at university. My mentor said ok, but she will continue as usual until I can prove that the way we have been taught is better. I gathered up to date evidence,wrote a referenced reflection on the comparison of techniques. I presented this to my mentor, along with a recent article supporting the up to date technique. She read through them, understood the benefits from changing her technique. My mentor ended up sharing the new knowledge with the other nurses that she worked with to make sure that they were also up to date, there was no hint of resentment but appreciation for being updated.
    Do not be afraid to call up people who are doing things that were once best practice. One of the roles of students is to help keep nurses up to date as the nursing professional is continually updating and improving.

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  • 'One of the roles of students is to help keep nurses up to date'. Actually, this is the employer's job. Full marks for your efforts, but they leave open the question of WHY your mentor had not been updated.

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  • Fran Entwistle

    Well done to Sophie Legg - the winner of our book competition!

    Email us your address Sophie and we'll get your book out to you - speakoutsafely@emap.com

    Thanks to everyone who entered!

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  • Yes Stella you are completely right. I meant that because nursing is continually evolving, it cannot always be possible to keep up to date with everything, hence students may bring new evidence to the attention of nurses they meet on placement. Although it is not their responsibility, as you said.
    My specific example was related to skin prep using an alcohol wipe before giving sub-cut injections, as there is lots of conflicting advice regarding its necessity.

    wahoo, i won! thanks! :)

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  • I would feign ignorance around correct SC technique and ask her how she knows how to do it correctly. I'd get her to demonstrate to me how to do is so I know how to do it properly.

    In an ideal world she would recognise her own mistakes and this would improve things.

    If she didn't then I would mention to her about the way we were taught at Uni and see if I could demonstrate proper technique.

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